Ingrid Jacobs, PH.D., P.a.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

10-11P Issued in AR

Legal business name

INGRID JACOBS, PH.D., P.A.

Practice address

1 E Center St Ste 333
Fayetteville, AR 72701-5303

Phone

(479) 236-9813

NPI assigned

Jun 22, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ingrid Jacobs, PH.D.

Title

Psychologist

Phone

(479) 236-9813

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1609162239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E CENTER ST STE 333",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E CENTER ST STE 333",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015303",
            "telephone_number": "479-236-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGRID JACOBS, PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "INGRID",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "479-236-9813",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "10-11P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.